<div class="layuimini-container">
    <form id="app-form" class="layui-form layuimini-form">
        
        <div class="layui-form-item">
            <label class="layui-form-label">提现用户id</label>
            <div class="layui-input-block">
                <input type="text" name="uid" class="layui-input" lay-verify="required" placeholder="请输入提现用户id" value="{$row.uid|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">提现单号</label>
            <div class="layui-input-block">
                <input type="text" name="cash_no" class="layui-input" lay-verify="required" placeholder="请输入提现单号" value="{$row.cash_no|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">提现银行卡id</label>
            <div class="layui-input-block">
                <input type="text" name="bank_id" class="layui-input" lay-verify="required" placeholder="请输入提现银行卡id" value="{$row.bank_id|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">提现金额</label>
            <div class="layui-input-block">
                <input type="text" name="cash_price" class="layui-input" lay-verify="required" placeholder="请输入提现金额" value="{$row.cash_price|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">提现状态 0提现中 1提现成功 2提现失败</label>
            <div class="layui-input-block">
                <input type="text" name="is_status" class="layui-input" lay-verify="required" placeholder="请输入提现状态 0提现中 1提现成功 2提现失败" value="{$row.is_status|default=''}">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">提现时间</label>
            <div class="layui-input-block">
                <input type="text" name="withdraw_time" class="layui-input" lay-verify="required" placeholder="请输入提现时间" value="{$row.withdraw_time|default=''}">
            </div>
        </div>
        <div class="hr-line"></div>
        <div class="layui-form-item text-center">
            <button type="submit" class="layui-btn layui-btn-normal layui-btn-sm" lay-submit>确认</button>
            <button type="reset" class="layui-btn layui-btn-primary layui-btn-sm">重置</button>
        </div>

    </form>
</div>